12 Jul 2021
Issue #65: CRACKING COVID: where we’ve been and where to next
Written by Nobel Laureate Professor Peter Doherty
Over the past week or so, a lot has been happening on the COVID-19 front with the Prime Minister, Scott Morrison, opening up the key question: what next? Much of that welcome discussion focuses on the question of how we exit the ‘gilded cage’ that has kept us safe as COVID-19 raged across the planet. Basically, along with the general willingness of the community to comply with specific policy settings, we’ve been protected by the fact that we are an island nation and that government at every level has engaged positively with solicited specialists (especially epidemiological modellers) and standing committees that advise Federal and State Chief Medical Officers. As I write this, the situation with the delta variant in NSW looks dangerous, but we can, I think, have confidence that the combination of effective policy, great contact-tracing capacity and responsible action through society will hammer the virus back down.
Implicit in the idea of achieving a ‘new normal’ by early to mid-2022 is the idea that we need a high level of ‘herd immunity’. Most think that can be achieved if 80% of the population is adequately vaccinated, with two shots of the AstraZeneca (AZ) vaccine or at least one dose of the Pfizer or Moderna mRNA vaccines. There is, of course, no issue re availability for AZ and, if the Europeans and Americans comply with what we understand to be their commitments re delivering the mRNA products, all Australians who are willing to get on board should (by the end of 2022) be at least 90% protected from being hospitalised with COVID-19. From what I’m hearing, it seems we are now organised to roll these vaccines out fast as soon as we have them.
One possible disruption would be if (as discussed last week #64) a virulent immune escape mutant of SARS-CoV-2 suddenly emerges and bypasses vaccine induced protection, a situation we know well from influenza. That’s much less likely for COVID-19 than for flu but there is, of course, no certainty. For the present, though, I think it is both a good communications strategy and sound policy to leave such discussion until, if we are indeed unlucky, such a problem arises.
The other issue with vaccination is vaccine hesitancy and even refusal. Any medical procedure has (like crossing the road or heading out on a small boat) some risk associated with it. Scientists like me are accustomed to thinking in terms of risk/benefit, or probability and relative risk, but that doesn’t permeate attitudes in the general community. One good analogy is wearing a seat belt in a car. Buckling up generally protects us but, on rare occasions, it can lead to a worse outcome in an accident. Most people accept that though, of course, the difference is that seat belts (or appropriate child restraint) are mandatory, while vaccination against COVID-19 is not.
One thing that should give people greater confidence about the integrity of the COVID-19 vaccination process is that the Australian authorities have been absolutely open about, say, the serious, but rare, clotting issue with the AZ vaccine. And they’ve recommended accordingly. Then, for those who think the vaccines were developed ‘too fast’, recognise the fact that both the AZ and the mRNA vaccines have now been given to hundreds of millions of people and have already saved enormous numbers of lives.
If you have friends and family members who are vaccine-hesitant, I suggest they go to SBS On Demand and view the 90 minutes of filmmaker Sonya Pemberton’s wonderful documentary Jabbed. This is now seven years old, so it doesn’t directly address the situation for COVID-19. But it’s a great, and balanced, discussion of both the risk/benefit equation for infectious diseases and how vaccines work.
Next week you can view the first public showing of Sonya’s new documentary Cracking COVID on the ABC. Working through her Melbourne-based production company Genepool Productions, with top cinematographer Harry Panagiotidis (Harry has more than 40 Australian and US film credits), Sonya used our Institute as a focal point, while also addressing the nature of this disease, including the somewhat mysterious but potentially disastrous long COVID. You will meet some terrific people and see something of the ‘back room’ story for COVID as it played out across the country, in Australian biomedical research institutes, universities, hospitals and government laboratories.
Using our Institute as an example is appropriate as, uniquely for this country, we are a joint venture partnership between the University of Melbourne and the Royal Melbourne Hospital and combine academic divisions, state public health laboratories, a clinical infectious diseases service and the WHO Collaborating Centre for Research and Reference on Influenza, all specialising in infectious diseases and immunology. Along with some smaller groups, these very different, but complementary activities come together under the leadership of Director, physician and researcher, Sharon Lewin, and Deputies Mike Catton and Andrew Brooks. You may already know some of these people from the TV. So, watch Cracking COVID on ABC channel 2, 8:30 PM Australian Eastern time on Tuesday, 13 July. Failing that, catch it later on ABC i-View. Journalists who’ve seen previews, including those at TV Week, give it a thumbs up and reckon it’s both engaging and easy to follow.